ABSTRACT

The rate of adolescent obesity has increased rapidly in recent years (Michalsky, Reichard, Inge, Pratt, & Lenders, 2012; Black, White, Viner, & Simmons, 2013; Treadwell, Sun, & Schoelles, 2008). In addition, obesity in adolescents is associated with a number of serious health outcomes. Given these factors, weight-loss surgery (WLS) is increasingly being turned to as one solution to promote weight loss, prevent the development of adult obesity, and change the course of many of the comorbidities associated with adolescent obesity. Evidence increasingly supports WLS as a viable option for weight-loss and health improvement in severely obese adolescents who have been carefully screened and selected, and thus it is not surprising that the rates of WLS within this population are also very much on the rise (Michalsky et al., 2012; Treadwell et al., 2008). However, WLS in adolescents is not without its risks and does not always lead to desired outcomes. Identifying factors and interventions that promote the likelihood of long-term success for adolescents undergoing this procedure is of high importance. It is critical to note that WLS is not for teens who have had an uncomplicated history of obesity but is reserved for only those adolescents who have multiple, significant medical comorbidities that threaten longevity and hamper other weight loss efforts. Based on our review of relevant research, our clinical experiences with this population, and our success in using this intervention with other populations, we propose that increasing the involvement of the adolescent’s family, through the implementation of family-based therapy for weight loss surgery (FBT-WLS), is likely to promote successful outcomes and minimize the risks associated with WLS in adolescents. In this chapter, we present background on the use of bariatric surgery to treat adolescent obesity, background on family involvement in treatment of pediatric obesity, background on family involvement in preparing teens for weight loss surgery, and present a proposed plan for implementing FBT-WLS. We finish with a presentation of clinical examples to support and illuminate our recommendations.